Narrative therapy

Michael White

Narrative therapy
Intervention
MeSH	D062525

Narrative therapy is a form of psychotherapy that seeks to help people identify their values and the skills and knowledge they have to live these values, so they can effectively confront whatever problems they face. The therapist seeks to help the person co-author a new narrative about themselves by investigating the history of those qualities. Narrative therapy claims to be a social justice approach to therapeutic conversations, seeking to challenge dominant discourses that it claims shape people's lives in destructive ways. The approach was developed during the 1970s and 1980s, largely by Australian social worker Michael White and David Epston of New Zealand.^[1]

While narrative work is typically located within the field of family therapy, many authors and practitioners report using these ideas and practices in community work, schools and higher education.^[2][3][4][5]

Identity

The narrative therapist focuses upon assisting people to create stories about themselves, about their identities, that are helpful to them. This work of "re-authoring identity" claims to help people identify their own values and identify the skills and knowledge they have to live these values. Through the process of identifying the history of values in people's lives, the therapist is able to co-author a new story about the person.^[6]

The story people tell about themselves and that is told about them is important in this approach which asserts that the story of person's identity determines what they think is possible for themselves. The narrative process allows people to identify what values are important to them and how they might use their own skills and knowledge to live these values.^[7]

Externalizing the problem

The concept of identity is important in narrative therapy. The approach aims not conflate people's identities with the problems they may face or the mistakes they have made. Rather, the approach seeks to avoid modernist, essentialist notions of the self that leads people to believe there is a biologically determined "true self" or "true nature". Instead, identity is seen as primarily social that can be changed according to the choices people make.^[8]

To separate people's identities from the problems they face, narrative therapy employs externalizing conversations. The process of externalization allows people to consider their relationships with problems, thus the narrative motto: “The person is not the problem, the problem is the problem.”^[1] So-called strengths or positive attributes are also externalized, allowing people to engage in the construction and performance of preferred identities.

Therapeutic Posture

In a narrative approach, the therapist aims to adopt a collaborative therapeutic posture rather than imposing ideas on people by giving them advice. Both the therapist and the people who consult them are seen as having valuable information both in terms of the process of therapeutic conversation and in terms of the content of these conversations. By adopting a posture of curiosity and collaboration instead, the therapist aims to give the implicit message to people that they have already knowledge and skills to solve the problems they face. When people develop solutions to their own problems on the basis of their own values, they become much more committed to implementing these solutions.^[9]

Common elements

Common elements in narrative therapy are:

• The assumption that narratives or stories shape a person's identity, as when a person assesses a problem in their life for its effects and influences as a "dominant story";
• An appreciation for the creation and use of documents, as when a person and a counselor co-author "A Graduation from the Blues Certificate";
• An "externalizing" emphasis, such as by naming a problem so that a person can assess its effects in his or her life, come to know how it operates or works in their life, relate their earliest history, evaluate it to take a definite position on its presence, and in the end choose their relationship to it.
• A focus on "unique outcomes" (a term of Erving Goffman) or exceptions to the problem that wouldn't be predicted by the problem's narrative or story itself.
• A strong awareness of the impact of power relations in therapeutic conversations, with a commitment to checking back with the client about the effects of therapeutic styles in order to mitigate the possible negative effect of invisible assumptions or beliefs held by the therapist.
• Responding to personal failure conversations^[10]

Method

In Narrative therapy a person's beliefs, skills, principles, and knowledge are seen as the means to help them regain their life from a problem(s). In practice a narrative therapist aims to help clients examine, evaluate, and change their relationship to a problem by acting as an “investigative reporter” who is not at the center of the investigation but is nonetheless influential; that is, this therapist poses questions that help people externalize a problem and then thoroughly investigate it.

Intertwined with this problem investigation is the uncovering of unique outcomes or exceptions to its influences, exceptions that are claimed to lead to rich accounts of key values and hopes—in short, a platform of values and principles that provide support during problem influences and later an alternate direction in life.

The narrative therapist, as an investigative reporter, has many options for questions and conversations during a person's effort to regain their life from a problem. These questions might examine how exactly the problem has managed to influence that person's life, including its voice and techniques to make itself stronger.

On the other hand, these questions might help restore exceptions to the problem's influences that lead to naming an alternate direction in life. Here the narrative therapist relies on the premise that, though a problem may be prevalent and even severe, it has not yet completely destroyed the person. So, there always remains some space for questions about a person's resilient values and related, nearly forgotten events. To help retrieve these events, the narrative therapist may begin a related re-membering conversation about the people who have contributed new knowledge or skills and the difference that has made to someone and vice versa for the remembered, influential person.

Outsider witnesses

In this particular narrative practice or conversation, outsider witnesses are invited listeners to a consultation. Often they are friends of the consulting person or past clients of the therapist who have their own knowledge and experience of the problem at hand. During the first interview, between therapist and consulting person, the outsider listens without comment.

Then the therapist interviews them with the instructions not to critique or evaluate or make a proclamation about what they have just heard, but instead to simply say what phrase or image stood out for them, followed by any resonances between their life struggles and those just witnessed. Lastly, the outsider is asked in what ways they may feel a shift in how they experience themselves from when they first entered the room.^[11]

Next, in similar fashion, the therapist turns to the consulting person, who has been listening all the while, and interviews them about what images or phrases stood out in the conversation just heard and what resonances have struck a chord within them.

In the end, an outsider witness conversation is often rewarding for witnesses. But for the consulting person the outcomes are remarkable: they learn they are not the only one with this problem, and they acquire new images and knowledge about it and their chosen alternate direction in life. The main aim of the narrative therapy is to engage in people's problems by providing the alternative best solution.

Criticisms of narrative therapy

To date, there have been several formal criticisms of narrative therapy over what are viewed as its theoretical and methodological inconsistencies, among various other concerns.^[12][13][14]

• Narrative therapy has been criticised as holding to a social constructionist belief that there are no absolute truths, but only socially sanctioned points of view, and that Narrative therapists therefore privilege their client's concerns over and above "dominating" cultural narratives.^[13][15]
• Several critics have posed concerns that narrative therapy has made gurus of its leaders, particularly in the light that its leading proponents tend to be overly harsh about most other kinds of therapy.^[13][15] Others have criticized narrative therapy for failing to acknowledge that the individual Narrative therapist may bring personal opinions and biases into the therapy session.^[13]
• Narrative therapy is also criticized for the lack of clinical and empirical studies to validate its many claims.^[16] Etchison & Kleist (2000) state that narrative therapy's focus on qualitative outcomes is not congruent with larger quantitative research and findings which the majority of respected empirical studies employ today. This has led to a lack of research material which can support its claims of efficacy.^[16]

See also

Theoretical foundations

• Constructivist epistemology
• Feminism
• Hermeneutics
• Postmodernism
• Poststructuralism

Related types of therapy

• Brief therapy
• Family therapy
• Logotherapy
• Response based therapy
• Script analysis
• Solution focused brief therapy

Other related concepts

• Dialogical self
• Lucid dream
• Narrative
• Film/video-based therapy

References

• Catrina Brown and Tod Augusta-Scott. Narrative Therapy: Making Meaning, Making Lives. Sage Publications. 2007.
• Winslade, John & Monk, Gerald. (2000) Narrative Mediation: A New Approach to Conflict Resolution. San Francisco: Jossey-Bass. ISBN 0-7879-4192-1
• White, M. (2005). Narrative practice and exotic lives: Resurrecting diversity in everyday life. Adelaide: Dulwich Centre Publications. pp 15.
• Etchison, M., & Kleist, D.M, Review of Narrative Therapy: Research and Review, Family Journal 8(1) 61-67 (2000)
• Freedman, Jill and, Combs, Gene (1996). Narrative Therapy: The social construction of preferred realities. New York: Norton. ISBN 0-393-70207-3.
• White, M. (2007). Maps of narrative practice. NY: W.W. Norton. ISBN 978-0-393-70516-4

Notes

1. White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York: WW Norton. ISBN 978-0393700985
2. (Nylund and Tilsen, 2006)
3. Dulwich Centre, 1997, 2000
4. Winslade, John & Monk, Gerald. (2000) Narrative Mediation: A New Approach to Conflict Resolution. San Francisco: Jossey-Bass. ISBN 0-7879-4192-1
5. (Lewis & Chesire, 1998)
6. Brown & Augusta-Scott, Narrative Therapy, 2007, p. 24
7. Brown & Augusta-Scott, Narrative Therapy, 2007, p. 36
8. Michael White, Maps of Narrative Practice, 2007, p. 139
9. Michael White. De-Centered Practice. Re-authoring Lives. 2001. p. 39
10. Narrative Means to Therapeutic Ends; Maps of Narrative Practice; White, M. (2000). Reflections on Narrative Practice Adelaide, South Australia: Dulwich Centre Publications
11. White, M. (2005). Narrative practice and exotic lives: Resurrecting diversity in everyday life. Adelaide: Dulwich Centre Publications. pp 15.
12. Fish, V., Post Structuralism in Family Therapy: Interrogating the Narrative/Conversational Mode. Journal of Family Therapy 19(3) 221-232 (1993)
13. Minuchin, S., Where is the Family in Narrative Family Therapy? Journal of Marital & Family Therapy, 24(4), 397-403 (1998)
14. Madigan, S., The Politics of Identity: Considering Community Discourse In The Externalizing of Internalized Problem Conversations, Journal of Systemic Therapies, 15(1), 47-62 (1996)
15. Doan, R.E., The King is Dead: Long Live the King: Narrative Therapy and Practicing What We Preach, Family Process 37(3), 379-385 (1998)
16. Etchison, M., & Kleist, D.M, Review of Narrative Therapy: Research and Review, Family Journal 8(1) 61-67 (2000)

External links

• Narrative Therapy Bibliography